The elderly are facing an increasing prevalence of chronic disease and rapidly escalating healthcare costs threatening independent living. Congestive heart failure (HF) is a growing health epidemic and is associated with significant morbidity, mortality and cost. We have developed and tested a non-invasive, minimally obtrusive, interactive remote monitoring sensor technology with on-board data processing algorithms in HF patients in a hospital setting. It enables on-body monitoring and integration of ECG, heart rate, breathing, and activity, with measures of weight and blood pressure, and is designed as a platform for physician-directed patient self-management. Our overall objective is to adapt, refine, test and validate this technology for use in HF patients outside the usual medical care environment to reduce readmissions and facilitate healthy independent living. An important component of our strategy is the incorporation of behavioral evaluations, to optimize tolerance, usability and adherence. The technology is designed to be part of an adaptable platform that will readily be expanded in the longer term to manage a wide range of related conditions. As such, it will have clear implications for maintenance of healthy independent living across a broad range of populations. Our test studies will be conducted in independently living elderly individuals, and our validation studies will be conducted in patients recently discharged after treatment for HF. Our specific aims are: 1. Adapt and refine our minimally obtrusive, interactive remote monitoring system to acquire ECG, heart rate, activity, breathing, weight and blood pressure data in an independent living center outside the hospital and medical care environment, with wireless transmission of data to a central data analysis hub. 2. Provide proof of effectiveness and usability of the end-to end remote monitoring solution in a free-living, regional population. 3. Validate the efficacy of the remote monitoring solution in reducing hospitalizations in independently living regional heart failure patients undergoing remote monitoring versus usual care. The findings in this proposal will have significant public health implications in terms of prevention of hospitalization for HF. Application of this solution will no only reduce hospital admissions and health care costs, but also improve functionality and promote healthy independent living. PUBLIC HEALTH RELEVANCE: The elderly face increasing chronic disease and heart failure in particular is a growing epidemic associated with high rates of death, suffering and cost. We have developed a minimally obtrusive, interactive remote monitoring system that enables on-body monitoring and integration of heart rate, breathing, and activity, with measures of weight and blood pressure. As a platform for physician directed patient self-management, our objective is to adapt, refine, test and validate this technology for use in heart failure patients outside th usual medical care environment. This project has significant public health implications, not only reducing health care costs and hospital admissions, but promoting healthy independent living.